title: Acute lymphoblastic leukemia presented as severe jaundice and hyperferritinemia: a case report.
abstract: Children with acute lymphoblastic leukemia (ALL) frequently present with hepatomegaly and mild liver functional impairment. Severe jaundice is rarely seen as a presenting feature. Such patients often present diagnostic dilemmas and therapeutic difficulties. Here we report a 15-year-old boy presenting with severe jaundice and hyperferritinemia, whose bone marrow smear showed B-lineage precursor ALL. We treated him with intravenous immunoglobulin, steroid, and etoposide; then his condition improved. ALL should be considered as a possible diagnosis in severely jaundiced children. Steroid and etoposide can be used as first aid when many chemotherapeutic drugs are contraindicated.
authors.affiliation: Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan.
authors.forename: Ling-Sai
authors.initials: LS
authors.lastname: Chang
authors.forename: Hong-Ren
authors.initials: HR
authors.lastname: Yu
authors.forename: Yu-Chieh
authors.initials: YC
authors.lastname: Chen
authors.forename: Say-Tin
authors.initials: ST
authors.lastname: Yeah
authors.forename: Mao-Meng
authors.initials: MM
authors.lastname: Tiao
authors.forename: Chih-Cheng
authors.initials: CC
authors.lastname: Hsiao
authors.forename: Jiunn-Ming
authors.initials: JM
authors.lastname: Sheen
mesh_terms: D000293:Adolescent; D005293:Ferritins / Q000097:blood*; D006801:Humans; D007565:Jaundice / Q000209:etiology*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood / Q000150:complications* / Q000188:drug therapy
chemical_list: D005293:Ferritins